One of the most striking features
of Lacanian psychoanalytic literature, as compared with the literature of other
analytic schools, is its amazing dearth of clinical case studies.  Even vignettes about analysands are rarely
to be found interspersed throughout Lacan-inspired texts.  Is this proof that Lacan is indeed guilty of
having fabricated a theoretical framework so heavily intellectualized that its
practical dimension, as the therapeutic stakes of the clinic, unduly suffers as
a result?  Apart from a few notable
exceptions, most Lacanian analysts remain silent about exactly what transpires
inside the walls of their consulting rooms. 
Rumors, rather than accurate reports, proliferate in response to this
silence (especially as crystallized in the stories about how Lacan himself
treated his patients).  After Lacan
sets itself apart by virtue of containing copious amounts of contemporary
clinical material, thus providing readers with a valuable glimpse into how a psychoanalytic
approach informed by Lacan treats various kinds of psychical afflictions.  This collection of essays shows how a
Lacanian clinic handles the sort of analysands landing on today’s analytic
couches (instead of, for example, rehashing once again Freud’s century-old case
studies).

The three contributors to this
volume (Willy Apollon, Danielle Bergeron, and Lucie Cantin) are all members of
the Montreal-based group GIFRIC (Groupe Interdisciplinaire Freudien de
Recherches et d’Interventions Cliniques et Culturelles).  In Lacanian circles, GIFRIC is best known
for its pioneering work with psychotics, and this collection outlines the core
theoretical and therapeutic ideas behind their clinical strategies for
psychotic patients.  Although, starting
with Freud, there’s been much debate about whether psychoanalysis can even
treat psychosis at all–many believe that analysis isn’t suited to handle the
extreme end of the psychopathological spectrum–GIFRIC adamantly insists that a
Lacan-informed analytic approach is capable of providing relief from painful
psychotic symptoms.  One of the keys,
the authors argue, is to undermine the psychotic’s absolute certainty in
his/her closed delusional system, to introduce a margin of doubt or suspicion
into these anguished solipsistic worlds (Lacan contends that a hallmark of
psychosis is the unusual degree of certainty such patients express in relation
to their versions of un-reality).  And,
they go on to maintain, psychoanalytic dream interpretation is especially
effective at accomplishing this goal in treatment.  Confronting the delusion itself head on is unlikely to succeed,
since the delusional patient is the authoritative expert in relation to the
idiosyncratic web of irrefutable meanings expressed therein; everything
confirms the delusion, and nothing could possibly contest or falsify it.  By contrast, psychotics, like everyone else,
are capable of being perplexed by the manifest content of dreams, by
experiencing bewilderment when faced by these strange and often confusing
mental products.  Through dreams as a
tangential angle of approach, the analyst can begin attempting to lead the
psychotic analysand into questioning his/her pathological take on reality.  The psychotic can, in this way, gradually
become a bit more comfortable accepting a degree of uncertainty, rather than
insisting on a total and exhaustive interpretation of the world on the basis of
a delusional system.  With the loosening
of the delusion’s grip through the erosion of the sense of certainty, the psychotic
patients treated in GIFRIC’s "388" clinic show improvements in their
symptoms and report feeling better. 
Such, in non-Lacanian parlance, is a rough outline of GIFRIC’s
contributions in this area.

However, the pieces assembled in
this collection range over a number of psychoanalytic topics.  For instance, in the course of discussing
psychosis, the authors elegantly summarize Lacan’s recasting of the Freudian
Oedipus complex as a mythical depiction of the drama in which the child is
introduced to the mediation of its libidinal economy through the entry into
both language and social structures (in which others and their desires must be
negotiated with).  Similarly, they
defend the more traditional Freudian-Lacanian Oedipal model against its
feminist and post-modern critics.  The
argument is made that the mother alone cannot be both the maternal nurturer as
well as the paternal legislator simultaneously.  According to Lacan, in order to avoid laying the groundwork for
later psychotic disturbances, the "paternal metaphor" must be brought
to bear upon "the desire of the mother" (put all too simply, the
child requires the reassurance that everyone in the family unit is answerable
to a "rule of law" standing above each and every particular
individual).  However, there are two
main problems with a single parent trying to play both roles at once:  on the one hand, the question of what higher
law governs the switching between the different parental positions/roles
remains unanswered for the child, thus leaving him/her stuck with the same
destabilizing anxieties as when faced with the enigma of an Other upon whom
he/she is abjectly dependent;  on the
other hand, a parent who pretends to "be everything" conveys the deceptive
(and potentially disastrous) message to the child that it’s possible to
"have it all," to avoid the limitations and constraints imposed upon
everyone by virtue of having to occupy a specific position in the
socio-symbolic order.  In analytic terms,
the figure of "super-mom" (a fantasy construct of certain
"anti-Oedipal" feminist discourses) fails to provide the stabilizing
benefits of the paternal third figure (loosely construed as Lacan’s
"Name-of-the-Father"), and risks encouraging a pathological denial of
castration (in both the narrow Freudian sense as well as the broad Lacanian
sense à la "symbolic castration").  The authors also furnish the readers with illuminating
discussions of other analytic disorders, such as hysteria, perversion, and
obsessional neurosis.

The common Lacanian thread binding
together this set of twelve essays has to do with the theme of jouissance
as impossible.  The Oedipal path leading
into the mediating matrix of social and linguistic networks–within this
matrix, the individual’s libidinal economy is subjected to numerous constraints
and conditions barring the uninhibited working of the drives in pursuit of
their gratifications–is a one-way street. 
That is to say, once symbolic castration (qua the irreversible
mediation of the libidinal economy by the symbolic order) has taken place, its
effects cannot be undone.  The
quasi-mythical "Real Thing" (as Lacan’s das Ding), the pure,
raw enjoyment supposedly lost to the drives during the course of
Oedipalization, becomes a forever-inaccessible impossibility.  Different pathological structures represent
various ways of dealing with this loss, with jouissance as something
impossible.  For example, in chapters
ten and eleven, Cantin analyzes both perversion and hysteria along these lines
(the pervert denies castration by insisting that he/she knows the secret means
of access to jouissance, while the hysteric avoids confronting the
necessary impossibility of jouissance by simultaneously treating its
loss as a painfully gratuitous contingency as well as looking for a
"master" who can provide this always-already stolen enjoyment).  Thus, as Cantin observes, the pervert and
the hysteric are apt to form a tightly bound couple, since the pervert offers
him/her-self as the authority on jouissance (as the uncastrated One)
ardently sought after by the hysteric. 
According to GIFRIC, neurosis, perversion, and psychosis can all be
effectively handled in analysis vis-à-vis an approach which addresses
them as distinct responses to the "trauma" of jouissance, to
the painful truth that unfettered enjoyment (as a sort of blissful "state
of nature") is, as Lacan puts it, "prohibited as such to the speaking
being."

 Apollon is already well known in English-language Lacanian
circles, having published a fair amount of work.  The two other contributors, Danielle Bergeron and Lucie Cantin,
are less familiar names to American readers of Lacan-oriented literature.  However, the essays by both of them are
clear, compelling, and insightful.  All
three authors do an excellent job of demonstrating that Lacan’s ideas are of
great use in the concrete therapeutic field (rather than being nothing more
than ornate academic abstractions). 
Additionally, After Lacan is not just for Lacanians.  In their helpful editorial introduction,
Robert Hughes and Kareen Ror Malone summarize this material in such a way that
those unfamiliar with Lacan are offered an avenue of entry into the essays that
follow.  Newcomers to Lacanian theory
will find the glossary of key terms at the end of the introduction especially
useful.  Overall, After Lacan is
a much-needed and long-overdue survey of the clinical workings of a form of
psychoanalysis inspired by Lacan. 
Perhaps, hopefully, other Lacanian analysts will take their lead from
GIFRIC and break a silence that has served only to stoke skepticism in the
wider analytic community.  With more
publications like this, Lacan might have a chance of exiting the confines of
the North American ivory tower and catching on amongst clinicians here.

© 2003 Adrian Johnston

Adrian Johnston, Ph.D.
holds a position as interdisciplinary research fellow in psychoanalysis at
Emory.

Categories: Psychoanalysis